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目的 探讨无张力阴道尿道中段悬吊术(TVT)治疗老年女性尿失禁的临床意义和疗效。 方法 采用SPRAC吊带系统对6例单纯性压力性尿失禁老年女性进行 TVT治疗,分析其疗效及并发症。 结果 6例TVT手术均在硬膜外麻醉下完成,平均手术时间 31.6 min,术中平均出血36.2 ml,5例手术后24 h内自行排尿,1例合并肥胖和阴道前壁膨出患者留置尿管 1 周后自行排尿。术后随访10~28个月,5例尿失禁治愈,1 例手术后 3 个月再次发生尿失禁,2 例术后伴不同程度的尿频、尿急,1例自觉耻骨后轻度不适。 结论 TVT易操作、创伤小、疗效好,对绝经后老年女性合并肥胖和阴道前壁膨出的压力性尿失禁患者治疗有明显疗效。
Objective To investigate the clinical significance and curative effect of tension-free vaginal urethra suspension (TVT) in the treatment of urinary incontinence in elderly women. Methods Six elderly patients with simple incontinence urinary incontinence underwent TVT treatment with the SPRAC harness system. The curative effect and complications were analyzed. Results All 6 TVT procedures were performed under epidural anesthesia. The average operation time was 31.6 min. The average intraoperative bleeding was 36.2 ml. Five cases of spontaneous urination were performed within 24 hours after operation. One case of obstruction with vaginal anterior wall bulging Tube 1 week after urination. Postoperative follow-up was 10-28 months, 5 cases of incontinence were cured, 1 case of urinary incontinence 3 months after surgery, 2 cases of postoperative with varying degrees of urinary frequency, urinary urgency, 1 case of conscious pubic post-mild discomfort. Conclusion TVT is easy to operate with less trauma and good curative effect. It has a significant effect on the treatment of stress urinary incontinence in elderly postmenopausal women with obesity and anterior vaginal wall bulging.